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D2 Fall > Indirect Exam 1 > Flashcards

Indirect Exam 1 Flashcards

1
Q

Describe an optimal restoration

A

Combo of biologic, mechanical, and esthetic properties

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2
Q

Which property?

Retention form

A

Mechanical

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3
Q

Which property?

Resistance form

A

Mechanical

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4
Q

Which property?

Deformation

A

Mechanical

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5
Q

Which property?

Conservation of tooth structure

A

Biologic

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6
Q

Which property?

Avoidance of overcontouring

A

Biologic

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7
Q

Which property?

Supragingival margins

A

Biologic

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8
Q

Which property?

Harmonious occlusion

A

Biologic

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9
Q

Which property?

Protection against tooth fracture

A

Biologic

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10
Q

Which property?

Minimum display of metal

A

Esthetic

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11
Q

Which property?

Max thickness of porcelain

A

Esthetic

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12
Q

Which property?

Porcelain occlusal surfaces

A

Esthetic

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13
Q

Which property?

Subgingival margins

A

Esthetic

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14
Q

Name 3 biological considerations

A

Adjacent teeth
Soft tissue
Pulp

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15
Q

How can soft tissue damage be prevented?

A

Retraction with aspirator tip, mirror, or isolite

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16
Q

What are 4 biological considerations in regards to the pulp?

A

Pulp size
Temp
Chemical action
Bacterial action

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17
Q

Name the 6 ways we can conserve tooth structure

A
  1. Partial coverage rather than complete coverage
  2. Prep of teeth with minimum practical convergence angle (taper) btwn axial walls
  3. Prep occlusal surface so reduction follows anatomical planes (gives uniform thickness to restoration)
  4. Prep axial surfaces so tooth structure is removed evenly
  5. Select conservative margin compatible with other principles of tooth prep
  6. Avoid unnecessary apical extension
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18
Q

The more apical the margin (subgingival), the __________ (more/less) conservative

A

less

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19
Q

What are the 4 types of crown materials?

A

PFM
PFZ
Monolithic ceramic
Full metal

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20
Q

Margin = ?

A

Finish line

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21
Q

What are the types of margin designs?

A

Bevel
Chamfer
Shoulder
Feather-edge

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22
Q

Which type of margin?

Advantages:

Removes unsupported enamel
Allows finishing of metal

A

Bevel margin

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23
Q

Which type of margin?

Disadvantage:

Can extend prep into sulcus

A

Bevel margin

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24
Q

Which type of margin?

Indications:

Facial margin of maxillary partial-coverage restorations
Inlay/onlay margins

A

Bevel margin

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25
Q

Which type of margin?

Advantages:

Fewer complications
Adequate bulk

A

Chamfer margin

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26
Q

Which type of margin?

Disadvantage:

J-lip

A

Chamfer margin

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27
Q

Which type of margin?

Indications:

Full metal, PFM, and some ceramics

A

Chamfer margin

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28
Q

Which type of margin?

Advantage:

Bulk of restorative material

A

Shoulder margin

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29
Q

Which type of margin?

Disadvantage:

Less conservative

A

Shoulder margin

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30
Q

Which type of margin?

Indications:

Facial margin of PFM crowns
All ceramic crowns

A

Shoulder margin

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31
Q

Which type of margin?

Advantage:

Conservative prep

A

Feather-edge margin

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32
Q

Which type of margin?

Disadvantages:

Not sufficient bulk
Requires metal margin

A

Feather-edge margin

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33
Q

Which type of margin?

Indication:

Long preps

A

Feather-edge margin

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34
Q

What are the 3 possible margin placements?

A

Supragingival
Epigingival
Subgingival

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35
Q

Which margin placement?

Easily finished, easily kept clean

A

Supragingival

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36
Q

Which margin placement?

Impressions easier to get without damaging soft tissue

A

Supragingival

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37
Q

Which margin placement?

Restorations can be easily evaluated at recall appts

A

Supragingival

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38
Q

Which margin placement?

Not ideal, places interface tooth/restoration right on gingival crest

A

Epigingival

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39
Q

Which margin placement?

Can create inflammation and gingivitis

A

Epigingival

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40
Q

Which margin placement?

More esthetic

A

Subgingival

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41
Q

Which margin placement?

Provides additional crown retention

A

Subgingival

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42
Q

Which margin placement?

Root sensitivity

A

Subgingival

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43
Q

Which margin placement?

Not indicated in pts with caries, erosion, subgingival restorations, and crown lengthenings

A

Subgingival

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44
Q

What are the occlusal considerations mentioned in lecture?

A

Rollercoaster
Supraerupted
Occlusal trauma
Titlted teeth

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45
Q

Feature of a tooth prep that resists dislodgement of a crown in a vertical direction or along path of placement

A

Retention form

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46
Q

Features of a tooth prep that enhance stability of a restoration and resist dislodgement along an axis other than the path of placement

A

Resistance form

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47
Q

Why should you prep with a green or black label diamond with heavy grit?

A

The rougher the surface better

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48
Q

Which gold alloys are used for intracoronal cast restorations?

A

Type I and II

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49
Q

Which gold alloys are used for crowns and FDPs?

A

Type III and IV

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50
Q

The thicker the cement, the __________ (stronger/weaker) the strength

A

weaker

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51
Q

The higher the SA, the _____________ (better/worse) the retention

A

better

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52
Q

The higher the axial walls, the ___________ (higher/lower) the SA

A

higher

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53
Q

The wider the prepped tooth, the ___________ (higher/lower) the SA

A

higher

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54
Q

What can cause a crown to dislodge?

A

Sticky food like caramel

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55
Q

What should be the degree of convergence of your prep?

A

6-10 degrees

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56
Q

Reduces stress on remaining tooth structure

A

Rounded internal line angles (no sharp edges!)

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57
Q

What is the ideal vs acceptable taper?

A

Ideal = 6-10 degrees
Acceptable = 10-20 degrees

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58
Q

How can you improve the resistance and retention of a crown in the case of a virgin tooth?

A

6-10 degree convergence
Conservative prep
Lower margins to have longer axial walls

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59
Q

What material can you use to improve the resistance and retention of a crown?

A

Stronger cement (ex: Panavia, a resin cement)

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60
Q

How can you improve the resistance and retention of a crown in the case of replacing or prepping a tooth that already has lost significant structure?

A

Retentive grooves
Prepare wider margin to reduce convergence
Build-up with pins

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61
Q

Long narrow channel or depression, such as indentation btwn tooth cusps or retentive features placed on tooth surfaces to augment the retentive characteristics of crown preps

A

Groove

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62
Q

A mesial and distal groove helps protect from what type of dislodgement?

A

Bucco-lingual dislodgement

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63
Q

A buccal and lingual groove helps protect from what type of dislodgement?

A

Mesio-distal dislodgement

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64
Q

What are the 7 key principles of preps?

A

Conservation of tooth structure
Resistance form
Retention form
Structural durability
Marginal integrity
Preservation of the periodontium
Aesthetic considerations

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65
Q

Which key principle of preps?

To avoid weakening tooth unnecessarily

A

Conservation of tooth structure

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66
Q

Which key principle of preps?

To avoid compromising the pulp

A

Conservation of tooth structure

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67
Q

Which key principle of preps?

To prevent dislodgment of a cemented restoration by apical or obliquely-directed forces

A

Resistance form

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68
Q

Which key principle of preps?

To prevent displacement of a cemented restoration along any of its paths of insertion, including long axis of the prep

A

Retention form

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69
Q

Which key principle of preps?

To provide enough space for a crown that is sufficiently thick to prevent fracture, distortion, or perforation

A

Structural durability

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70
Q

Which key principle of preps?

To prepare a finish line to accommodate a robust margin with close adaptation to minimize microleakage

A

Marginal integrity

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71
Q

Which key principle of preps?

To shape the prep so the crown is not over-contoured and its margin is accessible for optimal oral hygiene

A

Preservation of periodontium

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72
Q

Which key principle of preps?

To create enough space for aesthetic veneers where indicated

A

Aesthetic considerations

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73
Q

Specific direction in which a prosthesis is placed on the abutment teeth or implant

A

Path of placement/insertion/withdrawal

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74
Q

When visualizing the path of placement, how should you look at the center of the occlusal surface of your prep?

A

With 1 eye closed

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75
Q

What should be seen from the ideal path of insertion?

A

Prepped tooth

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76
Q

The path of placement helps to ensure the prep is not ____________ or _______________

A

undercut; overtapered

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77
Q

When visualizing the path of placement, what should be able to be seen at 360 degrees?

A

Margin (finish line)

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78
Q

When using indirect vision to visualize the path of placement, when should you stop maneuvering the mirror?

A

When prep is centered

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79
Q

What is the path of placement for posterior teeth?

A

Perpendicular to occlusal plane

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80
Q

What is the path of placement for maxillary posterior teeth?

A

Slightly buccal

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81
Q

What is the path of placement for mandibular posterior teeth?

A

Slightly lingual

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82
Q

What is the path of placement for anterior teeth?

A

Flared to facial, finding a mid-point btwn the abutment’s tooth axis

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83
Q

What classification of dental alloy?

Type I

A

Inlays

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84
Q

What classification of dental alloy?

Type II

A

Onlays

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85
Q

What classification of dental alloy?

Type III

A

Crowns/FDPs

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86
Q

What classification of dental alloy?

Type IV

A

RPDs

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87
Q

Type I hardness

A

Soft

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88
Q

Type II hardness

A

Medium

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89
Q

Type III hardness

A

Hard

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90
Q

Type IV hardness

A

Extra hard

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91
Q

What type of dental alloy?

PFM and Full Metal crowns

A

Type III

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92
Q

7 requirements for PFM crowns

A

High fusion temp to withstand porcelain firing
Thermal coefficient of expansion > than porcelain
Promote durable metal/porcelain bond
High mechanical properties
Biocompatible
Tarnish resistance
Usually nickel free

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93
Q

What are the available alloy systems?

A

Noble metal alloys
Base metal alloys

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94
Q

Which noble metal alloys are corrosion resistant?

A

Gold-based
Palladium-based

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95
Q

What does corrosion resistant mean?

A

Do not form stable oxides

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96
Q

Which metals oxidize to form a chromium oxide surface layer?

A

Base metals

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97
Q

Which alloy system is stronger: noble metal or base metal?

A

Base metal alloys

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98
Q

What are the main elements in base metal alloys?

A

Nickel and Cobalt

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99
Q

When base metals oxidize to form a chromium oxide surface layer, what is blocked? What does this prevent?

A

Blocks diffusion of oxygen
Prevents corrosion of underlying metal

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100
Q

What are the 3 main noble metals?

A

Gold (Au)
Platinum (Pt)
Palladium (Pd)

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101
Q

Which metal alloy?

60% noble metals
At least 40% gold

A

High noble metal alloy

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102
Q

Original PFM alloy (98% nobel metal)

A

Gold-Platinum-Palladium

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103
Q

First low-gold alternative alloy (50%)

A

Gold-Palladium-Silver

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104
Q

What improves the castability in the first low-gold alternative alloy?

A

Silver

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105
Q

Very popular noble metal alloy, has excellent mechanical properties

A

Palladium-Silver

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106
Q

Which metal alloy?

25% noble metals
No gold requirement

A

Noble metal alloy

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107
Q

What are the 3 options/combinations for noble metal alloy?

A

Palladium-Silver
Palladium-Copper-Ga
Palladium-Ga

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108
Q

Which noble metal alloy has 0-2% gold and 30-35% silver?

A

Palladium-Silver

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109
Q

Which noble metal alloy has at least 70% palladium?

A

Palladium-Copper-Ga

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110
Q

Which noble metal alloy is a dark oxide that is more difficult to mask, making it not very popular?

A

Palladium-Ga

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111
Q

What are the 4 options/combinations for base metal alloy?

A

Nickel-Cr
Be
Nickel
Cobalt-Cr

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112
Q

Which base metal alloy?

Not as burnishable as noble metals (gold, platinum, palladium)

A

Nickel-Cr

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113
Q

Which base metal alloy?

High modulus of elasticity, ideal for long-span FDPs

A

Nickel-Cr

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114
Q

Which base metal alloy?

Lower melting point and improves castability

A

Be

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115
Q

Which base metal alloy?

Toxic; associated with lung and nasal cancer

A

Nickel

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116
Q

Which base metal alloy?

9% of females are allergic

A

Nickel

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117
Q

Which base metal alloy?

0.9% of males are allergic

A

Nickel

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118
Q

Which base metal alloy?

No potential health problems

A

Co-Cr

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119
Q

Which base metal alloy?

Highest modulus of elasticity

A

Co-Cr

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120
Q

Which base metal alloy?

Finishing is very difficult

A

Co-Cr

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121
Q

Which base metal alloy?

High level of hardness

A

Co-Cr

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122
Q

Due to new advances of digital tech, many of today’s crowns are made with which alloy?

A

Co-Cr

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123
Q

What technique are Co-Cr alloys printed with?

A

Selective Laser Melting technique (SLM)

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124
Q

What are PFM and full metal crowns used for?

A

Single crowns
FDPs (1 or 2 pontics)

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125
Q

If cement films are < than ______ um, then a successful restoration is possible

A

120

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126
Q

What are the 4 theories of the porcelain/metal attachment mechanism?

A

Chemical bonding
Compression bonding
Mechanical retention
Van der waals forces (secondary)

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127
Q

The attraction btwn charged atoms that are in intimate contact, yet do not actually exchange electrons

A

Van der waals forces (secondary)

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128
Q

How are Van der waals forces (secondary) different from chemical bonding (primary)?

A

There is sharing/exchange of electrons in chemical bonding

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129
Q

The _________ (worse/better) the wetting of the metal surface w/ the liquid porcelain, the greater the Van der waals forces

A

better

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130
Q

Are Van der waals forces strong or weak?

A

Weak

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131
Q

How is mechanical retention achieved in metal casting?

A

Metal cast has microscopic irregularities;
Opaque porcelain flows into irregularities when fired

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132
Q

What kind of surface can porcelain fuse to?

A

Polished surfaces

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133
Q

T/F: Porcelain does not require a roughened surface to bond to metal, since it can fuse to polished surfaces

A

True

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134
Q

Air abrasion enhances mechanical retention surface irregularities (stress concentrations) while increasing the overall SA available for bonding

A

Aluminum oxide

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135
Q

What is porcelain strongest under?

A

Compression

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136
Q

What is porcelain weakest under?

A

Tension

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137
Q

If thermal expansion of the metal substructure is greater than that of the porcelain placed over it, the porcelain will ____________ during cooling

A

compress

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138
Q

When cooling a restoration, the metal contracts _________ (less/more) than the porcelain

A

more

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139
Q

The difference in contraction rates creates ___________ forces on metal and ______________ forces on porcelain

A

tensile; compressive

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140
Q

Without a wraparound effect in a full PFM crown, there is _________ (less/more) likelihood that this compression bonding will develop

A

less

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141
Q

Most significant mechanism

A

Chemical bonding

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142
Q

Describe the chemical bonding that happens in a crown

A

Porcelain bonds to oxides of metal substructure

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143
Q

What are the 2 hypotheses of chemical bonding?

A

Oxide layer bonds to metal on one side and porcelain on other side (grilled cheese)

Metal oxides are dissolved by opaque porcelain layer (2 pieces of bread on top of each other)

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144
Q

In chemical bonding, both covalent and ionic bonds are thought to form, but only a _______________ layer of oxides is believed to be required for chemical bonding to occur

A

monomolecular (single)

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145
Q

Describe steps of placing opaque porcelain on metal

A
  1. Opaque powder mixed w/ distilled water
  2. Thin wash layer applied w/ brush
  3. Coping dried & fired under vacuum
  4. 2nd opaque layer applied to mask the metal
  5. Coping gently vibrated to condense porcelain & remove excess water
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146
Q

Opaque layer of porcelain should be as ________ as possible, approximately _____ mm thick

A

thin; 0.3 mm

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147
Q

What type of crown?

Indicated for surveyed crown (RDP), malocclusion, FDP, endo

A

PFM
FMC

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148
Q

What type of crown?

Indicated when there’s a loss of dental structure

A

PFM

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149
Q

What type of crown?

Indicated for esthetics

A

PFM
All ceramic

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150
Q

What type of crown?

When a more conservative restoration is a reliable option

A

PFM
FMC

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151
Q

What type of crown?

Contraindicated for active caries and perio

A

PFM
FMC

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152
Q

What type of crown?

Contraindicated for young patients and pulp exposure

A

PFM
FMC (not as critical as PFM tho)

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153
Q

What type of crown?

Contraindicated when esthetics are an issue

A

FMC

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154
Q

What type of crown?

Advantage = strong, helps integrity of tooth (compared to onlays/inlays)

A

PFM

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155
Q

What type of crown?

Advantage = esthetics (compared to full metal)

A

PFM
All ceramic

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156
Q

What type of crown?

Advantage = permits correction of axial form for RDP tx

A

PFM
FMC

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157
Q

What type of crown?

Disadvantage = increased removal of dental structure compared to onlays/inlays

A

PFM (more than FMC)
FMC

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158
Q

What type of crown?

Subgingival margin on anterior segment to achieve esthetics; risk for perio

A

PFM

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159
Q

How many mm is the metal coping and porcelain on axial wall for PFM crown?

A

Metal coping = 0.3 mm
Porcelain = 1-1.2 mm

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160
Q

How many mm is the metal coping and porcelain on incisal edge for PFM crown?

A

Metal coping = 0.3 mm
Porcelain = 1.2-1.7 mm

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161
Q

What does a metal occlusion on a PFM crown allow for?

A

More conservative prep (as thin as 1 mm)
Stronger occlusal surface (ex: pt with bruxism)

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162
Q

When is a metal occlusion on a PFM crown indicated?

A

Limited interocclusal clearance

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163
Q

What is one downfall of a metal occlusion on a PFM crown?

A

Poor esthetics

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164
Q

Dental specialty pertaining to the diagnosis, tx planning, rehab, and maintenance of the oral function, comfort, appearance, and health of pts with clinical conditions associated w/ missing or deficient teeth and/or maxillofacial tissues using biocompatible substitutes

A

Prosthodontics

165
Q

Branch of prosthodontics concerned with replacement and/or restoration of teeth by artificial substitutes that are not readily removed from the mouth

A

Fixed prosthodontics

166
Q

A fixed prosthodontic restoration that is fabricated outside the pt’s mouth and cemented

A

Indirect restoration

167
Q

What are some common indirect restorations?

A

Inlays
Onlays
Crowns
Bridges
Veneers

168
Q

What are the 4 main goals of fixed prosthodontics?

A

Restore function/mastication
Restore aesthetics
Maintain health/integrity of arches
Support tx of problems related to TMJ

169
Q

Any dental prosthesis that is luted, screwed, or mechanically attached to natural teeth, tooth roots, and dental implant abutments that furnish the primary support for the dental prosthesis

A

Fixed dental prosthesis (FDP)

170
Q

Structure that directly receives thrust or pressure; an anchorage. A tooth or dental implant that serves to support and or retain a prosthesis

A

Abutment

171
Q

Part of a FDP that unites the abutment to the remainder of the restoration

A

FDP retainer

172
Q

Artificial tooth on FDP that replaces a missing tooth, restores its function, and fills the space previously occupied by clinical crown

A

Pontic

173
Q

Portion of FDP that unites the retainers and pontics

A

Connector

174
Q

Skeletal portion of prosthesis (usually metal) around which and to which are attached the remaining portions of the prosthesis to produce a finished restoration; frequently used to anchor a prosthesis to natural teeth

A

Framework

175
Q

Most gingival point of curvature along free gingival margin of a tooth

A

Gingival trigone/zenith

176
Q

Why do you want to match the new restoration to the contralateral tooth’s gingival trigone/zenith?

A

Achieve better esthetics

177
Q

Where is the gingival trigone/zenith? What is the exception

A

Distal to center of tooth

exception = lateral incisor, which is in midline

178
Q

Thin or thick gingiva biotype?

Narrower band of keratinized tissue, which may end in a wavy mucogingival junction

A

Thin

179
Q

Thin or thick gingiva biotype?

Perio probe is seen through gingiva while probing

A

Thin

180
Q

Thin or thick gingiva biotype?

Wide band of keratinized tissue

A

Thick

181
Q

Thin or thick gingiva biotype?

Short papilla

A

Thick

182
Q

Thin or thick gingiva biotype?

Squarish teeth

A

Thick

183
Q

Thin or thick gingiva biotype?

From occlusal view, the alveolar housing of the teeth is broad

A

Thick

184
Q

Thin or thick gingiva biotype?

Presents a thinner buccal plate and gingiva

A

Thin

185
Q

Thin or thick gingiva biotype?

Presents a thicker buccal plate and gingiva

A

Thick

186
Q

Combined width of CT and JE attachment formed adjacent to a tooth and superior to crestal bone

A

Biologic width

187
Q

When prepping a tooth for any kind of restoration, it’s important to place the finish line/margin on what?

A

Sound dental structure

188
Q

What happens if the finish line/margin is not placed on sound dental structure?

A

Higher risk of failure due to multiple margins

189
Q

What should you do in this situation?

A multi-rooted tooth has had bone loss or has super-erupted, and needs to be evaluated for its perio prognosis (especially on its furcation)

A

Crown fluting

190
Q

What does crown fluting allow for?

A

Cleansability

191
Q

Slot is incorporated on crown’s surface, coronal to the furcation

A

Crown fluting

192
Q

What margin is recommended to conserve as much dental structure as possible when crown fluting?

A

Feather edge or light chamfer

193
Q

Why should you round all internal line angles of your prep?

A

Reduce stress on prep
Less chance of crown breaking/wearing down
Allow crown to seat completely

194
Q

Used to measure thickness of a crown on a particular area

A

Crown gauge/caliper

195
Q

Useful when adjusting a crown/framework where limited space is available

A

Crown gauge/caliper

196
Q

What is the absolute minimum thickness of PFM metal coping, occlusal surface of full metal crown, and PFM coping + porcelain?

A

PFM metal coping: 0.3mm or greater (0.5mm ideally)
Occlusal surface of FMC: 1mm or greater
PFM coping + porcelain: 1.5mm or greater

197
Q

Describe the steps of removing an existing crown

A
  1. Section in equal halves in center of buccal surface - start at margin and finish at lingual surface
  2. Be sure to cut through all material until cement is exposed
  3. Break interproximal contact w/ flame diamond
  4. Use a crown spreader to wedge crown out
198
Q

No more than ______mm of a layer of porcelain should be applied on a FDP.

If porcelain exceeds this thickness, tell lab to create interproximal contacts in ________ to assure good porcelain support.

A

2mm; metal

199
Q

T/F: It is not possible to evaluate your PFM crown and unsupported porcelain on an X-Ray

A

FALSE; you should be evaluating your crowns/check unsupported porcelain by taking an X-Ray!

200
Q

How could you theoretically change the PFM crown in order to better support the porcelain and prevent fracture?

A

Extend design of metal framework

201
Q

___________ on the porcelain will increase the risk of fracturing a PFM crown

A

Porosity

202
Q

Band or ring used to encompass the root or crown of a tooth

A

Ferrule

203
Q

Provides a bracing or casing effect to protect integrity of the root

A

Ferrule

204
Q

Ferrule height is measured from the build-up core to the crown ________

A

margin

205
Q

Ideally, a ferrule effect of how many mm is wanted to minimize the risk of fracture?

A

1.5-2mm

206
Q

T/F: A post is NOT contraindicated if the ferrule height of 1.5-2mm is not met, but it compromises its prognosis

A

True

207
Q

What are you looking to create to obtain occlusal stability while mounting casts for crown fabrication?

A

Tripod effect

208
Q

How do you get the tripod effect for occlusal stability while mounting casts for crown fabrication?

A

Interocclusal registration

209
Q

Where should you put the interocclusal registration material?

A

Only on the teeth you’re restoring

210
Q

Form of mutually protected articulation in which the vertical and horizontal overlap of canine teeth disengage the posterior teeth in excursive movements of the mandible

A

Canine protected articulation

211
Q

The fabrication of a relationship of anterior teeth preventing posterior tooth contact in all eccentric mandibular movements

A

Anterior guidance

212
Q

Multiple contact relations between maxillary and mandibular teeth in lateral movements on the working-side whereby simultaneous contact of several teeth act as a group to distribute occlusal forces

A

Group function

213
Q

Complete intercuspation of opposing teeth independent of condylar position, sometimes referred to as the best fit of teeth regardless of condylar position

A

MIP

214
Q

Occlusion of opposing teeth when mandible is in centric relation; may or may not coincide with MIP

A

Centric occlusion

215
Q

Condyles articulate with thinnest avascular portion of respective disks with the complex in the anterio-superior position against the shapes of the articular eminences; independent of tooth contact

A

Centric relation

216
Q

Clinically discernible when mandible is directed superior and anteriorly; it is restricted to a purely rotary movement about the transverse horizontal axis

A

Centric relation

217
Q

What is essential in preventing secondary caries and perio when prepping a tooth?

A

Marginal fit of crown

218
Q

How should the gingival tissue look prior to prep?

A

Healthy (no inflammation)

219
Q

T/F: A complete impression of the margin/finish line is necessary

A

True duh

220
Q

What must be thoroughly exposed before taking an impression?

A

Gingival margin of prep

221
Q

What are the 2 goals when taking a final impression?

A

Full separation btwn tooth and gingiva
Control of intrasulcular fluid

222
Q

When is control of intrasulcular fluid critical when taking a final impression?

A

When hydrophobic impression material is used

223
Q

What can happen if there is not control of intrasulcular fluid before taking a final impression?

A

Incomplete margin on impression

224
Q

Combines chemical action with pressure packing; successful enlargement of gingival sulcus; control of fluids seeping from walls of gingival sulcus

A

Chemico-mechanical retraction

225
Q

A sulcular width of _____mm is required to prevent distortion of sulcular impression

A

0.2mm

226
Q

Control bleeding and promote tissue retraction; either for pre-impregnation or soaking of retraction cords

A

Hemostatic agents

227
Q

What are the 3 requirements for chemical agents in soft tissue management before taking an impression?

A

Effective in gingival displacement & hemostasis
Absence of irreversible damage to gingiva
Minimal systemic effects

228
Q

What is used as the vasoconstrictor in hemostatic agents?

A

Racemic epi

229
Q

What is racemic epi a combo of?

A

Levorotatory form of epi + Dextrorotatory form of epi

230
Q

What are the 2 limitations of vasoconstrictors in hemostatic agents?

A

Tissue injury (heals in 6-10 days)
Elevate BP/HR

231
Q

Metal salts that cause contraction of small blood vessels of gingival tissues, producing local tissue contraction and reduced capillary flow

A

Astringents

232
Q

Astringents are irritants in ______ concentrations and caustic in ______ concentrations

A

low; high

233
Q

Astringents can be what 2 types of sulfate?

A

Aluminum sulfate compounds
Ferric sulfate

234
Q

What are the 3 aluminum sulfate compounds for astringents?

A

Aluminum K+ sulfate
Aluminum sulfate
Aluminum Cl-

235
Q

Which aluminum sulfate compound for astringents?

100% concentration - less effective than epi but safer

A

Aluminum K+ sulfate

236
Q

Which aluminum sulfate compound for astringents?

Effective and biologically acceptable - not sufficient data

A

Aluminum sulfate

237
Q

Which aluminum sulfate compound for astringents?

Least irritating; interferes w/ setting of PVS impression material

A

Aluminum Cl-

238
Q

Which sulfate compound for astringents?

Very acidic; interferes w/ setting of PVS impression material; stains gingival tissue and all-ceramic crowns

A

Ferric sulfate

239
Q

Available in various sizes/designs; gently placed into sulcus to displace gingiva laterally away from tooth

A

Retraction cord

240
Q

What are the 3 desirable characteristics of cord?

A

Color
Absorbent
Different diameters

241
Q

Which characteristic of cord?

Maximize contrast with gingiva and tooth

A

Color

242
Q

Which characteristic of cord?

Allow uptake of liquid medicaments

A

Absorbent

243
Q

Which characteristic of cord?

Accommodate the various morphologies of gingival sulcus

A

Different diameters

244
Q

What are the 3 types of configurations for retraction cord?

A

Twisted
Braided
Knitted

245
Q

Which cord technique?

Impression when gingival tissue is healthy and prep is supragingival

A

Single cord

246
Q

Which cord technique?

Placed in the sulcus and removed immediately before impression

A

Single cord

247
Q

Which cord technique?

Retraction about the width of the cord

A

Single cord

248
Q

Which cord technique?

Often no satisfactory results – tearing of the impression material

A

Single cord

249
Q

Which cord technique?

Leads to poor access and collapsed tissue

A

Single cord

250
Q

Which cord technique?

Used in single or multiple preps; useful when tissue health is compromised and impression can’t be delayed

A

Double cord

251
Q

Which cord technique?

Preferred technique

A

Double cord

252
Q

Which cord technique?

Thin cord packed first and left in place for impression

A

Double cord

253
Q

Which cord technique?

The second, and thicker, cord is impregnated with hemostatic agent and left in place for ~4-10 min, and removed before impression is taken

A

Double cord

254
Q

Which cord technique?

First cord left in place, reducing the tendency of the gingival cuff to recoil and displace impression material

A

Double cord

255
Q

Which cord technique?

Better control of gingival hemorrhage and exudates; prevents tearing of impression material

A

Double cord

256
Q

Which cord technique?

First cord acts as sulcus liner to protect epithelium

A

Double cord

257
Q

Name the retraction cord diameters from smallest to largest

A

000 to #3

258
Q

Which cord diameter should be used?

Lower/first cord in double-cord technique

A

000, 00, 0

259
Q

Which cord diameter should be used?

Used for front teeth with sensitive and thin gingiva

A

000

260
Q

Which cord diameter should be used?

Used for front teeth when prepping/repairing veneers or other subgingival restorations

A

00, 0

261
Q

Which cord diameter should be used?

Protection for front teeth and premolars during tooth prep at gum level or subgingival

A

1

262
Q

Which cord diameter should be used?

Upper/2nd cord in double cord technique

A

2, 3

263
Q

Which cord diameter should be used?

Premolars and molars

A

2, 3

264
Q

Which cord diameter should be used?

Posterior teeth with thick, pronounced gingiva

A

3

265
Q

Cord overlap should always be in the _________ area, where gingival tissue is bulkier

A

interproximal

266
Q

What type of crown?

Advantage = strongest restoration; keeps tooth integrity and doesn’t suffer from porcelain chipping

A

FMC

267
Q

What type of crown?

Advantage = most conservative full coverage restoration

A

FMC

268
Q

What type of crown?

Disadvantage = not esthetic

A

FMC

269
Q

What type of crown?

Disadvantage = electric pulp vitality test can’t be performed

A

FMC

270
Q

What are the 4 all ceramic materials for crowns?

A

Feldspathic porcelain
Lithium disilicate porcelain (Emax)
PFZ
Monolithic zirconia

271
Q

Which prep design?

Feldspathic porcelain

A

All ceramic prep

272
Q

Which prep design?

Lithium dislicate porcelain (Emax)

A

All ceramic prep

273
Q

Which prep design?

PFM

A

PFM prep

274
Q

Which prep design?

PFZ

A

PFM prep

275
Q

Which prep design?

FMC gold

A

FMC prep

276
Q

Which prep design?

Monolithic zirconia

A

FMC prep

277
Q

What type of crown?

Contraindicated for limited interocclusal space (clearance)

A

All ceramic

278
Q

What type of crown?

Difficulty maintaining a dry working field (when bonded)

A

All ceramic

279
Q

What type of crown?

Heavy occlusal load (bruxer, opposing an implant supported crown)

A

All ceramic

280
Q

What type of crown?

Advantage = wear resistance (but wears opposing natural structure, so always polish)

A

All ceramic

281
Q

What type of crown?

Advantage = biocompatible

A

All ceramic

282
Q

What type of crown?

Advantage = controlled anatomy and better fit

A

All ceramic

283
Q

What type of crown?

Advantage = color stable

A

All ceramic

284
Q

What type of crown?

Disadvantage = cost and time

A

All ceramic

285
Q

What type of crown?

Disadvantage = brittleness

A

All ceramic

286
Q

What type of crown?

Disadvantage = wears opposing dentition (always polish!)

A

All ceramic

287
Q

What type of crown?

Disadvantage = repair limitations

A

All ceramic

288
Q

What type of crown?

Disadvantage = difficult intraoral finishing

A

All ceramic

289
Q

What are the 6 characteristics of all ceramic crowns?

A

High melting point
Low thermal/electrical conductivity
High compressive strength
Low tensile strength
High hardness
Brittle

290
Q

What is the thermal requirement of all ceramic crowns? (ON EXAM)

A

Thermal expansion coefficient < metal
Fuses at a temp < metal

291
Q

What are the chemical and optical characteristics of all ceramic crowns?

A

Unaffected by high temp

292
Q

What are the 6 different ways all ceramic crowns can be classified?

A

Composition
Translucency
Processing method
Firing temp
Fracture resistance
Abrasiveness

293
Q

Which type of all ceramic crown?

Predominantly glass

A

Feldspathic porcelain

294
Q

Which type of all ceramic crown?

High content of glass

A

Feldspathic porcelain

295
Q

Which type of all ceramic crown?

Highly esthetic

A

Feldspathic porcelain

296
Q

Which type of all ceramic crown?

Very translucent

A

Feldspathic porcelain

297
Q

Which type of all ceramic crown?

Weak ceramic

A

Feldspathic porcelain

298
Q

Which type of all ceramic crown?

Particle-filled glass

A

Lithium disilicate porcelain (Emax)

299
Q

Which type of all ceramic crown?

Less translucent than feldspathic porcelain

A

Lithium disilicate porcelain (Emax)

300
Q

Which type of all ceramic crown?

Stronger ceramic

A

Lithium disilicate porcelain (Emax)

301
Q

Which type of all ceramic crown?

Polycrystalline

A

Zirconia

302
Q

Which type of all ceramic crown?

No glass; metal oxide

A

Zirconia

303
Q

Which type of all ceramic crown?

Tough and less susceptible to crack propagation

A

Zirconia

304
Q

Which type of all ceramic crown?

Strongest all ceramic material

A

Zirconia

305
Q

Which type of all ceramic crown?

Coefficient of thermal expansion slightly lower than that of metal

A

Feldspathic porcelain

306
Q

Which type of all ceramic crown?

Fuses at temp lower than that of metal

A

Feldspathic porcelain

307
Q

Which type of all ceramic crown?

Poor conductors

A

Feldspathic porcelain

308
Q

Which type of all ceramic crown?

Good compressive strength

A

Feldspathic porcelain

309
Q

Which type of all ceramic crown?

High shrinkage after firing

A

Feldspathic porcelain

310
Q

Which type of all ceramic crown?

Technique sensitive

A

Feldspathic porcelain

311
Q

Which type of all ceramic crown?

Must be etch/bond cemented

A

Feldspathic porcelain

312
Q

Which type of all ceramic crown?

Used for all-ceramic restorations and to overlay PFM restorations

A

Feldspathic porcelain

313
Q

What are feldspathic porcelain crowns made up of?

A

Feldspar
Leucite
Quartz (silica)
Kaolin
Glass modifiers
Opacifiers
Color pigments/frits
Glazes

314
Q

Which component of Feldspathic porcelain?

Naturally occurring minerals composed of Potash (K2O), soda (Na2O), alumina, and silica

A

Feldspar

315
Q

Which component of Feldspathic porcelain?

Lowest fusing component, which melts first and flows during firing, initiating these components into a solid mass

A

Feldspar

316
Q

Which component of Feldspathic porcelain?

Ground to fine particles and after fusing, it becomes the matrix of the porcelain

A

Feldspar

317
Q

Which component of Feldspathic porcelain?

Gives translucency to porcelain

A

Feldspar

318
Q

Which component of Feldspathic porcelain?

Crystalline mineral that is formed when feldspar is melted

A

Leucite

319
Q

Which component of Feldspathic porcelain?

The greater of this content, the lower risk of crack propagation

A

Leucite

320
Q

Which component of Feldspathic porcelain?

Hot-press ceramics have high amounts of these crystals and are considered reinforced glass ceramics

A

Leucite

321
Q

Which component of Feldspathic porcelain?

Strengthens the fired porcelain restoration

A

Quartz (silica)

322
Q

Which component of Feldspathic porcelain?

Highly refractory; remains unchanged at temp normally used in firing porcelain, and thus contributes stability to mass during heating by providing framework for other ingredients

A

Quartz (silica)

323
Q

Which component of Feldspathic porcelain?

Ground to fine particles; acts as a filler in porcelain restoration

A

Quartz (silica)

324
Q

Which component of Feldspathic porcelain?

Used as a binder

A

Kaolin

325
Q

Which component of Feldspathic porcelain?

Increases moldability of unfired porcelain

A

Kaolin

326
Q

Which component of Feldspathic porcelain?

Imparts opacity to finished porcelain product

A

Kaolin

327
Q

Which component of Feldspathic porcelain?

Interrupts integrity of quartz (silica) network

A

Glass modifiers

328
Q

Which component of Feldspathic porcelain?

Act as flux

A

Glass modifiers

329
Q

Which component of Feldspathic porcelain?

Oxides of K+, Na+, Ca2+, or basic oxides

A

Glass modifiers

330
Q

Which component of Feldspathic porcelain?

Zirconium, cerium, tin, and uranium oxides

A

Opacifiers

331
Q

Which component of Feldspathic porcelain?

Used in the opaque and dentin (body) porcelains

A

Opacifiers

332
Q

Which component of Feldspathic porcelain?

Fe/Ni, Cu, MgO, TiO2, and Co oxide

A

Color pigments/frits

333
Q

Which component of Feldspathic porcelain?

To provide appropriate shade and characterize restoration (cracks, fissures, etc)

A

Color pigments/frits

334
Q

Which component of Feldspathic porcelain?

Fired at low temp

A

Color pigments/frits

335
Q

What color is chrome oxide?

A

Green

336
Q

What color is cobalt oxide?

A

Blue

337
Q

What color is platinum or iron oxide?

A

Gray

338
Q

What color is vanadium oxide?

A

Yellow/brown

339
Q

What color is chromium-tin oxide?

A

Pink

340
Q

Which component of Feldspathic porcelain?

Very high content of feldspar

A

Glaze

341
Q

Which component of Feldspathic porcelain?

Purpose is to melt and flow over surface of restoration, giving it a polished/shiny appearance

A

Glaze

342
Q

Which component of Feldspathic porcelain?

Diminishes occlusal wear against opposing natural dentition

A

Glaze

343
Q

Which component of Feldspathic porcelain?

Low fusing temp

A

Glaze

344
Q

Which type of all ceramic crown?

Commercially known as Emax (Ivolcar)

A

Lithium disilicate

345
Q

Which type of all ceramic crown?

~70% lithium disilicate crystals

A

Lithium disilicate

346
Q

Which type of all ceramic crown?

Stronger than feldspathic porcelain

A

Lithium disilicate

347
Q

Which type of all ceramic crown?

Not as esthetic (translucent) as feldspathic porcelain

A

Lithium disilicate

348
Q

Which type of all ceramic crown?

No deformation during sintering; doesn’t shrink

A

Lithium disilicate

349
Q

Which type of all ceramic crown?

Monochromatic porcelain

A

Lithium disilicate

350
Q

Which type of all ceramic crown?

Can be bond cemented or luted

A

Lithium disilicate

351
Q

Which type of all ceramic crown?

Hot pressed or milled manufacturing

A

Lithium disilicate

352
Q

Which type of all ceramic crown?

Standard composition:
SiO2 (57-80%)
LiO2
K2O
P2O2
ZrO2
ZnO

A

Lithium disilicate

353
Q

Which type of Lithium disilicate crown?

“Blue” stage; easier to mill, softer material

A

Milled

354
Q

Which type of Lithium disilicate crown?

40% lithium meta-disilicate crystals

A

Milled

355
Q

Which type of Lithium disilicate crown?

Treated at 1550 degrees F

A

Milled

356
Q

Which type of Lithium disilicate crown?

Crystal size “blue” stage = 0.5 um

A

Milled

357
Q

Which type of Lithium disilicate crown?

Crystal size sintered = 3-6 um

A

Milled

358
Q

Found naturally as zircon, mainly in Australia, Brazil, India, Russia, South Africa, USA

A

Zirconium

359
Q

Zirconium oxide (ZrO2)

A

Zirconia

360
Q

At room temp, can be found at it’s monoclinic phase

A

Zirconia

361
Q

When heated to 2138 degrees F, it transforms from monoclinic to tetragonal phase, along with a shrinkage of 3-5%

A

Zirconia

362
Q

Zirconia + yttrium oxide

A

Yttria-stabilized zirconia

363
Q

Maintains tetragonal properties when cooled to room temp; ideal characteristics for dental use

A

Yttria-stabilized zirconia

364
Q

Fracture resistant over 1000 MPa

A

Yttria-stabilized zirconia

365
Q

Phenomenon whereby a material undergoes one or more phase transformations which result in an almost instantaneous change in volume of that material

A

Transformation toughening

366
Q

Triggered by a change in the stress state of
the material, such as an increase in tensile stress, and acts in opposition to the applied stress

A

Transformation toughening

367
Q

When zirconia goes from the tetragonal phase to the monoclinic phase, what happens?

A

Volume increases by 25%

368
Q

Which type of crown undergoes transformation toughening?

A

Zirconia

369
Q

Which type of crown requires a 1mm margin width?

A

Zirconia

370
Q

Blocks/pucks are made my highly compressed ___________ powder

A

zirconia

371
Q

99.9% of zirconia restorations are made through which system?

A

CAD/CAM

372
Q

Zirconia blocks/pucks come partially ________ for milling. Restorations are milled ___________ (25%). They are then fired to 2732 degrees F to fully _______ - this is called the ___________ phase.

A

fired; oversized; sinter; tetragonal

373
Q

T/F: Zirconia is only offered as a bright white opaque color

A

FALSE; at first it could only be offered as a bright white, but now it’s available in different shades/translucencies

374
Q

The more opaque/less esthetic the crown, the __________ (stronger/weaker) the crown

A

stronger

375
Q

The more translucent/esthetic the crown, the ___________ (stronger/weaker) the crown

A

weaker

376
Q

What is the most translucent and therefore weakest crown type?

A

Feldspathic porcelain (predominantly glass)

377
Q

What crown type is medium translucency and therefore medium strength?

A

Lithium disilicate (particle-filled glass)

378
Q

What is the most opaque and therefore the strongest crown type?

A

Zirconia (polycrystalline)

379
Q

What are the 4 processing methods to make a crown?

A

Powder liquid building
Slip casting
Hot-pressed ceramic
Milled (CAD/CAM)

380
Q

Describe the powder liquid building processing method

A
  1. Mix porcelain powder and distilled water
  2. Ceramic slurry condensed by vibration to remove excess liquid; tissue used to absorb liquid as well
  3. Avoid voids as it weakens the porcelain
  4. Placed on furnace to remove moisture and condense porcelain
  5. Feldspathic porcelain overlaying
381
Q

Describe the slip-casting processing method

A
  1. Porous core infiltrated w/ a lanthanum-based glass
  2. Produces glassy phase and a crystalline infrastructure (alumina, spinel, zirconia-alumina)
382
Q

Which processing method is not popular anymore?

A

Slip-casting

383
Q

When compared to power liquid building, the slip-casting and hot-pressed ceramics processing methods result in __________ (greater/less) defects and __________ (greater/less) strength

A

less; greater

384
Q

Describe the hot-pressed ceramics processing method

A
  1. Restoration is waxed using lost-wax technique
  2. Plasticized ceramic ingot pressed into investment mold
385
Q

The hot-pressed ceramics processing method is used to make what?

A

Lithium disilicate crowns
Feldspathic porcelain crowns
Cores

386
Q

Compared to milling (CAD/CAM), the hot-pressed ceramics processing method results in _________ (better/worse) adaptation of restorations and _________ (greater/less) strength

A

better; greater

387
Q

Describe the milled CAD/CAM processing method

A

Scan prep, design crown, mill

388
Q

What does CAD/CAM stand for?

A

Computer aided design
Computer aided manufacturing

389
Q

The milled CAD/CAM processing method is used to make what?

A

Single/multiple units
Abutments
Bars
Casts
Guards
Custom trays
Core

390
Q

What are the popular systems used in the milled CAD/CAM processing method?

A

E4D
Cerec
iTero
3shape

391
Q

When compared to powder liquid building, the milled CAD/CAM processing method results in a _________ monolithic block with no _________

A

solid; bubbles

392
Q

When compared to hot-pressed ceramics, the milled CAD/CAM processing method results are very __________, but not as good as pressed

A

accurate

393
Q

Which processing method is SUPER popular due to time of manufacturing and cost?

A

Milled CAD/CAM

394
Q

What is the firing temp of denture teeth?

A

High-fusing: 2350-2500 degrees F

395
Q

What is the firing temp of crowns, FDPs, inlays, and onlays?

A

Medium-fusing: 2000-2350 degrees F

396
Q

What is the firing temp of veneering on PFM restorations?

A

Low-fusing: 1600-2000 degrees F

397
Q

What is the firing temp of titanium and its alloys?

A

Ultra-low-fusing: <1600 degrees F

398
Q

What is the fracture resistance of feldspathic porcelain?

A

100-150 MPa

399
Q

What is the fracture resistance of pressed lithium disilicate?

A

400 MPa

400
Q

What is the fracture resistance of milled lithium disilicate?

A

360 MPa

401
Q

What is the fracture resistance of in-ceram alumina using the slip-casting processing method?

A

600 MPa

402
Q

What is the fracture resistance of in-ceram spinell using the slip-casting processing method?

A

250 MPa

403
Q

What is the fracture resistance of in-ceram zirconia using the slip-casting processing method?

A

700 MPa

404
Q

What is the fracture resistance of zirconia and metal framework?

A

> 1000 MPa

405
Q

Porcelains are known to _______ the opposing natural dentition

A

wear

406
Q

________ (low-fusing porcelains) were developed to finer-sized leucite particles in lower concentrations to reduce abrasiveness

A

Glazes

407
Q

Ideally, we want to polish and then ______ porcelains

A

glaze

408
Q

Remember to _______ crowns after adjusting occlusion intraorally

A

polish

409
Q

___________ is the most abrasive material if not polished, since it is the strongest of all. If left unpolished, it will wear the opposing dentition faster

A

Zirconia

D2 Fall (37 decks)

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